Kornimate/medical-research-clean huggingface dataset:
college mental health project

Conditions: Depression

Summary: depression is common and debilitating disorder which, among college students, is predictive of significant problems including higher rates of dropout and suicidal behaviors. despite viable psychotherapeutic and pharmacological options, the majority of depressed college students, like others in the general population, do not pursue treatment. further, barriers to care, both those involving practical issues and psychological factors, lead to high attrition rates from treatment, resulting in modest effect sizes in effectiveness trials. in reaction to these alarming figures and as a means of increasing accessibility and retention, effective internet-based treatment for depression have been developed and tested. despite increased availability, response to internet-based treatment continues to vary substantially, yet, controlled trials show that a meaningful proportion of patients who receive internet-based therapy recover. identifying individuals with a high likelihood of responding to internet-based treatment would enable clinicians to target this inexpensive treatment only to the patients with a high probability of responding; allowing more intensive treatments to be reserved for patients who would not respond to internet-based therapy. the development of a system to make this determination would represent a major advance and address an unmet need. icare is an online depression treatment that has been adapted for college students (e.g., language used, problems discussed, embedded images). prior work by the developers of icare have tested the internet-based treatment in diverse samples of depressed adults, and prior meta-analytic research has demonstrated that psychological treatments for depression in college students are as effective relative to trials carried out among depressed adults. the overarching goal of the study is to: (a) test whether depressed college students utilize icare, (b) identify psychosocial and clinical characteristics that increase the likelihood of icare utilization, and (c) identify multivariate characteristics that predict treatment response.


Eligibility criteria:
inclusion criteria: * aged 18-25 years; * enrolled as a first year student at a participating institution; * english fluency; * mild or moderate depression: (i) phq-9 score 10-14 or (ii) phq-9 score 15-19; * provide online consent form. exclusion criteria: * severe depression: (i) phq-9 score ≥20; * endorse "3" (nearly every day) on item 9 of the phq-9; * no internet access

Keywords: internet-based treatment
dusting vs basketing in rirs: a single-center prospective randomised trial

Conditions: Urolithiasis

Summary: the investigator aims to perform a prospective and randomized controlled trial comparing the safety and efficacy of active basket extraction of fragments and stone dusting during the rirs.

rirs has been widely adopted and used by urologists worldwide in the management of renal stones due to less invasiveness and efficacy, especially in small to moderate-sized renal stones. rirs has several advantages over swl for stones less than 2 cm diameter. most importantly, removing the stone in one session without the need for other treatment modalities. furthermore, the application of rirs has expanded to larger stones reaching up to 35 mm in some cases,in spite of not being the first line therapy for the larger stones. rirs has advantages over the pcnl especially concerning complications. namely lower or no bleeding events and the less invasiveness of rirs. options for the treatment of intrarenal stones include fragmenting the stone then extracting large fragments using a basket or dusting the stone into very small fragments then leaving the (dust) to pass spontaneously. the idea of dusting in rirs emerges as a counterpart of the originally taught fragmentation and basketing of the stones. aiming to reduce multiple entries and exits for the renal system and ultimately not requiring uas or baskets during the surgery. thus theoretically decreasing operative time and costs with the same sfrs, in addition to minimizing the risk of ureteral injury . so there is a debate amongst surgeons whether to laser the stone to dust or fragment and retrieve intra-renal fragments. eau guidelines on the surgical management of urolithiasis stated that dusting strategies should be limited to the treatment of large renal stones. without clearly differentiating between dusting or fragmentation and basketing. cho et al; favored fragmentation technique especially for large renal stones because the dust in dusting technique may affect visualization and obscure small stone fragments. but this was an opinion and not built on a direct comparative study. until now, there is no consensus on how to achieve optimal stone clearance once the primary stone is fragmented with lithotripsy. and to date, no prospective randomized study has addressed the practice of active extraction vs. spontaneous passage

Eligibility criteria:
inclusion criteria: 1. patients must be a suitable operative candidate for rirs 2. age ≥18 years 3. normal renal function 4. asa score ⅰ and ⅱ 5. single renal stone ≤20mm or multiple stones the conglomerate diameter (additive maximal diameter of all stones on axial imaging of computed tomography) up to 20 mm exclusion criteria: 1. pregnant subjects 2. uncorrected coagulopathy and active urinary tract infection (uti) 3. prior ipsilateral endourological procedure history, such as rirs, pcnl, urs and url 4. patients who underwent transplant or urinary diversion. 5. congenital abnormalities.

Keywords: rirs renal stones efficacy safety
ultrafiltration on coagulation performance in cardiac surgery

Conditions: Cardiac Valve Disease

Summary: in cardiac surgery patients with cpb-induced dilutional coagulopathy, ultrafiltration (uf) was applied to reduce free water and concentrate all blood components before the weaning from cpb. the impact of uf on the clot strength is determined by analyzing the changes of maximal clot formation in extem assay (mcf-extem) in the rotem test in patients who underwent elective cardiac valve surgery in kumc.

in cardiac surgery patients, ultrafiltration (uf) was applied to reduce free water and concentrate all blood components during cardiopulmonary bypass (cpb). concentrating plasma substrate of uf would be beneficial in attenuating cpb-induced dilutional coagulopathy. this study was to investigate whether muf affected viscoelastic profiles during cpb for cardiac surgery. patients who underwent elective cardiac surgery and muf at the end of cpb during january 2019-december 2021 are recruited. using the patients' electronic medical records, the values of maximum clot firmness of extem assay (mcf-extem) of rotational thromboelastometry (rotem) test before and after applying muf are retrospectively analyzed. as the primary measure, we determine the changes of mcf-extem after applying muf. with an assumption that muf increased mcf-extem, the receiver operating characteristic (roc) analysis is applied to mcf-extem change. the area under the roc curve is determined and the cut-off value is estimated with specificity and sensitivity in youden's j statistics. the change of mcf-extem in patients who show mcf-extem less than the cut-off value is analyzed. the changes of hematocrit (hct) before and after applying muf is also determined.

Eligibility criteria:
inclusion criteria: * patients underwent cardiac surgery during jan 2019-dec 2021 * patients underwent moderate hypothermic cpb * patients underwent ultrafiltration during cpb * patients underwent rotem tests (extem assays and fibtem assay) before and after applying ultrafiltration exclusion criteria: * patients underwent packed rbc transfusion \> 3 units during cpb * patients underwent ultrafiltration but the removed free water was \< 250 ml * patients underwent deep hypothermia

Keywords: ultrafiltration cardiac valve disease viscoelastic test cardiopulmonary bypass
comparative clinical study between colistin-tigecycline combined therapy versus colistin-meropenem combined therapy in treatment of blood stream infections with multidrug-resistant klebsiella pneumoniae

Conditions: Treatment of Blood Stream Infections Due to Multidrug-Resistant Klebsiella Pneumoniae

Summary: this prospective, comparative study is evaluating the effectiveness and adverse effects of using colistin at a loading dose of 9 million international units (miu) followed by 4.5 miu every 12 h (q12 h) + tigecycline at a loading dose of 100 mg followed by 50 mg every 12 h (q12 h) versus colistin + meropenem 2 g q8 h in treating blood stream infections due to multidrug-resistant (mdr) klebsiella pneumoniae. the aims of the current study are to investigate and evaluate the therapeutic activity and side effects of colistin-meropenem combined therapy versus colistin-tigecycline combined therapy in treatment of patients with multiple drug resistant (mdr)-klebsiella pneumonia bacteraemia the primary goal is comparing 14 day mortality between critically ill patients with mdr gram-negative klebsiella pneumoniae infection as evaluation of the therapeutic activity of colistin - tigecycline vs. colistin - meropenem combined therapies. the secondary goal is comparing the comorbidities (nephrotoxicity, hepatotoxicity, neurotoxicity, hematological changes) between critically ill patients with mdr gram-negative klebsiella pneumoniae infection who will be treated with colistin - tigecycline versus colistin - meropenem combined therapies. method: a total of 60 patients were divided into two groups (30 patients each); the first group received intravenous colistin 9 miu iv infusion over 2 hours loading dose followed by maintenance dose 4.5 miu iv infusion over 2 hours q12 h plus intravenous tigecycline 100 mg iv infusion over 1 hour loading dose followed by maintenance dose 50 mg iv infusion over 1 hour q12 and the second group received intravenous colistin 9 miu iv infusion over 2 hours loading dose followed by maintenance dose 4.5 miu iv infusion over 2 hours q12 h plus intravenous meropenem 2 g iv infusion over 30 minutes q8 h


Eligibility criteria:
inclusion criteria: * patients with blood stream infection caused by mdr k. pneumoniae, as defined by infectious diseases society of america (idsa), who were hospitalised in the general icu, confirmed with carbapenem-resistant k. pneumoniae-positive culture results from blood sample within the previous 5 days exclusion criteria: * all patients without a mdr carbapenem-resistant k. pneumoniae-positive culture isolated from the blood. in addition, the following patients are excluded: patients with a glasgow coma scale (gcs) score of \ 34 or \>15, respectively, and risk of mortality \>85% or \>80% on the first day of colistin administration, respectively \[27,28\]. moreover, patients who received i.v. colistin combination therapies for \<72 h are excluded from further analysis

Keywords: colistin tigecycline meropenem
observational evaluation of atopic dermatitis in pediatric patients

Conditions: Dermatitis Atopic

Summary: primary objectives: * to describe the characteristics of pediatric patients with moderate to severe atopic dermatitis (ad) whose disease is not adequately controlled with topical therapies or when those therapies are not medically advisable. * to evaluate the time-course of ad and selected atopic comorbidities. secondary objectives: * to characterize disease burden and unmet need. * to describe real-world treatment patterns (eg, dosing regimens, treatment duration, and reasons for discontinuation and/or switching). * to document the real-world effectiveness and safety of treatments.

the study duration is 120 months.

Eligibility criteria:
inclusion criteria: * patients with moderate to severe ad, according to the investigator's assessment; * currently receiving systemic treatment (including phototherapy) for atopic dermatitis or currently on topical treatment, but otherwise candidates for systemic treatment. exclusion criteria: * concurrent participation in an interventional clinical trial which modifies patient care. the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
noninvasive ventilation breathing test guiding weaning in patients with acute hypoxic respiratory failure

Conditions: Acute Hypoxic Respiratory Failure

Summary: sbt, as a routine extubation strategy for invasive mechanical ventilation, has been widely recognized. however, in recent years, studies have found that sbt may lead to delayed extubation, which has been confirmed in copd patients but has not yet been widely accepted in patients with acute hypoxic respiratory failure. both invasive mechanical ventilation and non-invasive mechanical ventilation are positive pressure ventilation, with the essential difference being the human-machine interface. the safe inspiratory pressure for non-invasive mechanical ventilation should not exceed 20cmh2o (1cmh2o=0.098 kpa). if the cause of respiratory failure is relieved or removed, respiratory function improves, and the patient has good airway protection ability and can tolerate non-invasive ventilation, the endotracheal tube can be removed as soon as possible to switch to non-invasive mechanical ventilation, thereby shortening the time of invasive mechanical ventilation and reducing the risk of complications. this study trial aims to identify the timing of early extubation sequential non-invasive mechanical ventilation in patients with acute hypoxic respiratory failure through non-invasive ventilation breathing tests, providing a basis for updating the process of invasive mechanical ventilation extubation.

all the patients included will be randomly assigned to receive non invasive ventilation breathing test protocol or sbt protocol.

Eligibility criteria:
inclusion criteria: * adult patients who have been admitted to the intensive care unit (icu) with acute hypoxic respiratory failure. oxygenation index less than 300mmhg, have undergone tracheal intubation, and are anticipated received invasive mechanical ventilation for more than 24 hours. exclusion criteria: * • age over 80 years, * pregnancy, * consciousness disorders or intracranial hypertension caused by various reasons, * neuromuscular disorders, * severe cardiac dysfunction (new york heart association class iii or iv, acute coronary syndrome or persistent ventricular tachycardia), * cardiogenic shock or after major cardiac surgery, * severe liver and kidney failure, * severe malnutrition, * injury to the upper airway or nose and face, making it impossible to wear a nose (face) mask, * severe agitation, severe agitation, expected to be unable to cooperate with non-invasive mechanical ventilation.
compression is life in cardiac arrest - fatigue study

Conditions: Cardiac Arrest

Summary: context: chest compressions represent an important physical effort leading to fatigue and cardiopulmonary resuscitation quality degradation. despite a known harmful effect of chest compressions interruptions, current guidelines still recommend provider switch every 2 minutes. feedback impact on chest compressions quality during an extended cardiopulmonary resuscitation remains to be assessed. study design: simulated prospective monocentric randomized crossover trial. participants and methods: sixty professionals rescuers of the pre-hospital care unit of university hospital of caen (doctors, nurses and ambulance drivers) are enrolled to performed 10 minutes of continuous chest compression on manikin (resuscianne®, laerdal), twice, with and without a feedback device (cprmeter®). correct compression score (the main criterion) is defined by reached target of rate, depth and leaning at the same time (recorded continuously). hypothesis: feedback device delay fatigue effect arises during cardiopulmonary resuscitation.


Eligibility criteria:
inclusion criteria: * operational staff of university hospital of caen pre-hospital unit exclusion criteria: * medical contraindication * refusal
study to understand usage and effect of saxagliptin as first add-on after metformin in indian type 2 diabetes mellitus patients

Conditions: Type 2 Diabetes

Summary: this is a multicentre, non-interventional, prospective, observational study which would be conducted in india to understand the usage and effect of saxagliptin as first add-on therapy after metformin. the study will enroll type 2 diabetes mellitus (t2dm) patients who were inadequately controlled with metformin alone and have been recently prescribed saxagliptin as an add-on to metformin.

this is a multicentre, non-interventional, prospective, observational study which would be conducted in india to understand the usage and effect of saxagliptin as first add-on therapy after metformin. the study will enroll type 2 diabetes mellitus (t2dm) patients who were inadequately controlled with metformin alone and have been recently (i.e. within past 15 days) prescribed saxagliptin as an add-on to metformin. the investigator/designee would get signed informed consent from potential subjects of the study. the patients who meet all inclusion and none of the exclusion criteria will be enrolled in the study. these patients will then be assigned a patient identification number for the study. the investigator/designee will collect the information as per the study schedule. this will be considered as visit 1 of the patients. the patients will be managed as per the routine clinical practice of the physician for their condition and this study will neither interfere/advise the investigators/designee for any drug/medication to be prescribed to the patients nor prescribe any intervention to them.the enrolled patients would then be asked to visit their respective study sites after 3 months ( +7 days) for the visit-2 of study. around 50 study centers throughout india will be selected with a goal of enrolling up to 1500 patients (approximately 30 subjects each per site). the study will be initiated after obtaining written approval of independent/institutional ethics committee and written informed consent of the patient.

Eligibility criteria:
inclusion criteria: 1. patients willing to provide informed consent. 2. female or male patients aged 18 years or above. 3. patients with known case of type 2 diabetes mellitus. 4. patients with inadequate glycaemic control taking metformin monotherapy (minimum dose of 500 mg od) for at least 3 months. 5. patients who have recently (last 15 days) been prescribed saxagliptin in addition to metformin. exclusion criteria: 1. patients with type 1 diabetes mellitus. 2. patients taking glucose lowering drugs apart from metformin or saxagliptin. 3. any medical condition of the patient which in the opinion of investigator would interfere with safe completion of the study. 4. pregnant or lactating women. 5. women of childbearing potential not ready to use an effective barrier contraceptive method during the study.

Keywords: t2dm, diabetes
early laser treatment for diabetic eye disease in china : a pilot randomized trial

Conditions: Diabetic Retinopathy

Summary: to compare immediate laser pan-retinal photocoagulation (prp) treatment of severe or very severe non proliferative diabetic retinopathy (npdr) stage versus deferral of treatment until the appearance of any proliferative diabetic retinopathy (pdr) in rural and urban patients in china. interview data from some patients and survey data from ophthalmologists in the study hospitals will help determine acceptability of early treatment, and how to overcome barriers to increased use of this option.

china now has the world's largest number of diabetic persons. population studies show that only 10% of chinese rural-dwellers with dr receive therapy. the current standard approach to treatment of dr often requires patients to return for multiple examinations over years, before they reach trial-proven criteria for treatment. this long process is ill-suited to support good compliance with care in low-resource settings. our recent published review suggests that earlier prp treatment, which could reduce the burden of compliance, may be clinically effective and cost effective, but the current evidence base is insufficient to make a firm recommendation.

Eligibility criteria:
inclusion criteria: * adults aged \>= 18 years with untreated dr at severe or very severe npdr stage in either one or both eyes, according to the clinical opinion of the investigator. * sufficiently clear ocular media to allow visualization of the retina and retinal photography in either eye. * capable of giving informed consent. exclusion criteria: * dr at later stage of retinopathy than severe or very severe (eg, two or more of the 4-2-1 criteria are met) npdr in either eye, but a patient may be enrolled if one eye has severe or very severe npdr and the fellow eye has prp-treated pdr and has been stable after treatment. * clinically significant macular edema in either eye. * dense cataracts or other media opacity preventing visualization of the retina in the eye. * history of previous surgical or laser treatment for dr or other retinal conditions in a study eye, including history of anti-vegf or corticosteroid injection or focal laser for dme within 6 months, or any history of scleral buckle, vitrectomy or other retinal detachment repair. * history of other retinal vascular disorders including crvo, crao, brvo, brao in the study eye. * previous cataract or glaucoma surgery is specifically allowed if performed ≥ 6 weeks prior to enrollment. * pregnancy. * severe renal insufficiency treated with hemodialysis treatment, kidney transplant, pancreatic transplant, and intensive insulin therapy initiated within 4 months. * nystagmus, unable to cooperate with laser treatment.

Keywords: diabetic retinopathy pan-retinal photocoagulation proliferative non-proliferative